for people ages 50 years and up (full criteria)
Healthy Volunteers
healthy people welcome
study started
estimated completion
Principal Investigator
by Maile Young Karris (ucsd)
Headshot of Maile Young Karris
Maile Young Karris



Chronic pain impacts a large proportion of aging people living with HIV (aPLWH) and involves factors directly related to HIV (neurotoxicity) and psychosocial co-morbidities common in aPLWH (i.e. social isolation and loneliness). The investigators hypothesize that novel interventions that acknowledge these psychosocial co-morbidities may improve the efficacy of chronic pain management and minimize the use of potentially dangerous medications. This grant proposes to adapt and pilot a pain psychotherapy approach using group acceptance and commitment therapy (ACT) in aPLWH with chronic pain.

Official Title

Acceptance and Commitment Therapy to Address the Psychosocial Co-Morbidities of Chronic Pain in Aging People Living With HIV


Chronic pain affects a very high proportion of aging people living with HIV (aPLWH) and is thought to be related to both direct toxicity of HIV and antiretroviral therapy (ART) and by psychosocial factors that negatively affect pain (i.e. loneliness, HIV stigma). PLWH are also at increased risk for prescription opiate misuse. However as PLWH age, non-opiate medications used for pain can contribute to other negative outcomes such as falls, altered mental status and gastrointestinal bleeding. Thus there is a critical need for the development of novel interventions in the management of chronic pain in aPLWH that consider the psychological co-morbidities of aging with HIV and that can minimize the need for prescription medications. Acceptance and commitment therapy (ACT) has previously been evaluated in older persons with chronic pain and has demonstrated higher levels of satisfaction and efficacy when compared to cognitive behavioral therapy (CBT). ACT has never been evaluated in aPLWH for chronic pain, but has theoretical advantages over CBT for this population. Specifically several negatively modifying factors of CBT efficacy such as cognitive deficits are common in aPLWH. The overarching objective of this study is to determine the acceptability and feasibility of an ACT intervention for the management of chronic pain adapted to aPLWH. To accomplish this objective the investigators will 1) train lay personnel to perform ACT to determine feasibility of this approach for future implementation, 2) conduct uncontrolled group ACT in aPLWH to generate participant feedback and questionnaire data to inform ACT adaption with the assistance of a steering commitee, and 3) conduct a pilot randomized controlled trial (RCT) evaluating the acceptability of adapted ACT compared to pain education. At completion of this grant the investigators expect to have successfully trained lay personnel to perform group ACT, adapted ACT from quantitative and qualitative data collected from an uncontrolled study of group ACT, and determined whether ACT is acceptable and feasible as an intervention in aPLWH. These expected outcomes may benefit other aging populations with chronic pain that are enriched for psychosocial co-morbidities such as persons who inject drugs, the socioeconomically disadvantaged, and racial or gender minorities. This proposal is aligned with the Office of AIDS Research High Priorities to better understand "HIV-associated comorbidities" which includes pain and to "Reduce Health Disparities in treatment outcomes of those living with HIV/AIDS" and with the National Pain Strategy to "expand investment ... in the development of safe and effective pain treatments."


HIV/AIDS, Chronic Pain, HIV, Acceptance and Commitment Therapy, Behavioral Intervention, Older Adults, Acceptance and Commitment Therapy (ACT), Chronic Pain Education


You can join if…

Open to people ages 50 years and up

  • HIV seropositive
  • Diagnosis of chronic non cancer pain
  • English speaking
  • Deemed appropriate for study by primary care provider
  • Consents to participation

You CAN'T join if...

  • Cancer associated pain
  • Unwillingness to participate in audio recorded sessions
  • Enrollment in hospice
  • Moderate to severe neurocognitive deficits (MOCA < 16)
  • Currently undergoing other psychotherapy for chronic pain


  • AntiViral Research Center accepting new patients
    San Diego California 92103-8208 United States

Lead Scientist at University of California Health

  • Maile Young Karris (ucsd)
    I am a board certified internal medicine and infectious diseases physician who has been caring for persons living with HIV since 2004. I care for a variety of persons living with HIV but have a special interest in the successful aging of persons living with HIV.


accepting new patients
Start Date
Completion Date
University of California, San Diego
Study Type
Expecting 50 study participants
Last Updated